Daily Steps Threshold to Improve Cardiovascular Disease Risk Factors During the Year After an Acute Coronary Syndrome

Houle, Julie; Valera, Béatriz; Gaudet-Savard, Thierry; Auclair, Audrey; Poirier, Paul

doi:10.1097/hcr.0000000000000021

Cited by 20 publications

(27 citation statements)

References 13 publications

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“…Physical activity is vital for recovery after cardiac disease, and there is strong evidence for reduced morbidity and mortality when cardiac rehabilitation is exercise based 2–5. Walking is a simple physical activity that improves cardiovascular capability 6–9. Activity monitors, such as step counters, are designed to monitor walking activity, and step counters have been used to observe activity and as a motivational tool to support physical activity in clinical settings 7…”

Section: Introductionmentioning

confidence: 99%

Accuracy of a step counter during treadmill and daily life walking by healthy adults and patients with cardiac disease

et al. 2017

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BackgroundStep counters have been used to observe activity and support physical activity, but there is limited evidence on their accuracy.ObjectiveThe purpose was to investigate the step accuracy of the Fitbit Zip (Zip) in healthy adults during treadmill walking and in patients with cardiac disease while hospitalised at home.MethodsTwenty healthy adults aged 39±13.79 (mean ±SD) wore four Zips while walking on a treadmill at different speeds (1.7–6.1 km/hour), and 24 patients with cardiac disease (age 67±10.03) wore a Zip for 24 hours during hospitalisation and for 4 weeks thereafter at home. A Shimmer3 device was used as a criterion standard.ResultsAt a treadmill speed of 3.6 km/hour, the relative error (±SD) for the Zips on the upper body was −0.02±0.67 on the right side and −0.09 (0.67) on the left side. For the Zips on the waist, this was 0.08±0.71 for the right side and -0.08 (0.47) on the left side. At a treadmill speed of 3.6 km/hour and higher, the average per cent of relative error was <3%. The 24-hour test for the hospitalised patients showed a relative error of −47.15±24.11 (interclass correlation coefficient (ICC): 0.60), and for the 24-hour test at home, the relative error was −27.51±28.78 (ICC: 0.87). Thus, none of the 24-hour tests had less than the expected 20% error. In time periods of evident walking during the 24 h test, the Zip had an average per cent relative error of <3% at 3.6 km/hour and higher speeds.ConclusionsA speed of 3.6 km/hour or higher is required to expect acceptable accuracy in step measurement using a Zip, on a treadmill and in real life. Inaccuracies are directly related to slow speeds, which might be a problem for patients with cardiac disease who walk at a slow pace.

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Section: Introductionmentioning

confidence: 99%

Accuracy of a step counter during treadmill and daily life walking by healthy adults and patients with cardiac disease

et al. 2017

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“…Walking is suitable for cardiac patients because it is safe and feasible for almost all patients [ 22 - 24 ]. Step counters are recognized tools to count steps and measure walking activity, and they represent an important motivational tool to measure and increase adherence to physical activity [ 17 , 25 , 26 ]. Studies of cardiac patients’ use of step counters show an increase of physical activity with their use [ 18 , 21 , 25 , 27 - 31 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Patients’ Walking Activity Determined by a Step Counter in Cardiac Telerehabilitation: Data From the Intervention Arm of a Randomized Controlled Trial

Thorup¹,

Hansen²,

Grønkjær³

et al. 2016

J Med Internet Res

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BackgroundWalking represents a large part of daily physical activity. It reduces both overall and cardiovascular diseases and mortality and is suitable for cardiac patients. A step counter measures walking activity and might be a motivational tool to increase and maintain physical activity. There is a lack of knowledge about both cardiac patients’ adherence to step counter use in a cardiac telerehabilitation program and how many steps cardiac patients walk up to 1 year after a cardiac event.ObjectiveThe purpose of this substudy was to explore cardiac patients’ walking activity. The walking activity was analyzed in relation to duration of pedometer use to determine correlations between walking activity, demographics, and medical and rehabilitation data.MethodsA total of 64 patients from a randomized controlled telerehabilitation trial (Teledi@log) from Aalborg University Hospital and Hjoerring Hospital, Denmark, from December 2012 to March 2014 were included in this study. Inclusion criteria were patients hospitalized with acute coronary syndrome, heart failure, and coronary artery bypass grafting or valve surgery. In Teledi@log, the patients received telerehabilitation technology and selected one of three telerehabilitation settings: a call center, a community health care center, or a hospital. Monitoring of steps continued for 12 months and a step counter (Fitbit Zip) was used to monitor daily steps.ResultsCardiac patients walked a mean 5899 (SD 3274) steps per day, increasing from mean 5191 (SD 3198) steps per day in the first week to mean 7890 (SD 2629) steps per day after 1 year. Adherence to step counter use lasted for a mean 160 (SD 100) days. The patients who walked significantly more were younger (P=.01) and continued to use the pedometer for a longer period (P=.04). Furthermore, less physically active patients weighed more. There were no significant differences in mean steps per day for patients in the three rehabilitation settings or in the disease groups.ConclusionsThis study indicates that cardiac telerehabilitation at a call center can support walking activity just as effectively as telerehabilitation at either a hospital or a health care center. In this study, the patients tended to walk fewer steps per day than cardiac patients in comparable studies, but our study may represent a more realistic picture of walking activity due to the continuation of step counter use. Qualitative studies on patients’ behavior and motivation regarding step counter use are needed to shed light on adherence to and motivation to use step counters.Trial RegistrationClinicalTrails.gov NCT01752192; https://clinicaltrials.gov/ct2/show/NCT01752192 (Archived by WebCite at http://www.webcitation.org/6fgigfUyV)

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“…В настоящем исследовании под влиянием регулярных и длительных ФТ у пациентов с разным РП имелась позитивная модификация уровней кардиоваскулярных ФТ. На такую благоприятную способность систематических ФТ указывают и другие исследователи [15].…”

Section: Discussionunclassified

Clinical effects of a one-year cardiac rehabilitation program using physical training after myocardial infarction in patients of working age with different rehabilitation potentials

Бубнова

Аронов

2019

Cardiovasc Ther Prev

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ФГБУ "Национальный медицинский исследовательский центр профилактической медицины" Минздрава России. Москва, Россия Цель. Изучить эффективность кардиореабилитации (КР), основанной на годичных физических тренировках (ФТ) умеренной интенсивности, при разном уровне реабилитационного потенциала (РП) у больных, перенесших острый инфаркт миокарда в трудоспособном возрасте. Материал и методы. В исследование включены 300 пациентов через 3-8 нед. после острого инфаркта миокарда, рандомизированные в группы: основную "О" (n=155) для физической реабилитации и контрольную "К" (n=145) с последующим разделением каждой группы на три подгруппы в зависимости от уровня РП, классифицируемого по толерантности к физической нагрузке (ТФН) при нагрузочном тесте: высокий уровень-ТФН >100 Вт, средний->50-≤100 Вт и высокий-≤50 Вт. Проводились ФТ умеренной интенсивности 3 раза в нед. в течение года. Все пациенты получали стандартную терапию. Результаты. Под влиянием ФТ повышались мощность и длительность ФН при нагрузочном тесте, соответственно, при низком РП на 87,5% и 62,2% (р<0,001), среднем РП-на 51,1% и 44,9% (р<0,001), высоком РП на 13,9% и 15,0% (р<0,001). В подгруппах "К" эти показатели увеличились в меньшей степени при низком и среднем РП, а при высоком РП достоверно снизились. После ФТ при любом уровне РП уменьшался конечный систолический размер, и увеличилась фракция выброса левого желудочка, а при высоком РП имелось также снижение конечного диастолического размера. У пациентов без ФТ, напротив, размер левого предсердия несколько вырос при низком и высоком РП. После года ФТ индекс массы тела уменьшался при любом РП, с большим эффектом при высоком РП на 4,6% (р<0,001) в отличие от не тренировавшихся пациентов. Повседневная двигательная активность после года ФТ увеличилась, особенно при низком РП на 28,4% (р<0,05), а при отсутствии ФТ даже снижалась при низком РП на 29,6% (р<0,05). У тренирующихся пациентов с любым РП понизился уровень холестерина (ХС) липопротеидов низкой плотности на фоне повышения холестирина липопротеидов высокой плотности. При отсутствии ФТ наблюдался рост триглицеридов. При любом уровне РП на фоне ФТ сократились частота приступов стенокардии, количество сердечно-сосудистых осложнений и дней временной нетрудоспособности, что улучшало качество жизни. Заключение. Годовая программа КР, основанная на систематических ФТ умеренной интенсивности, приводит к позитивному клиническому эффекту при любом уровне РП пациента. Особенно заметны клиническая польза от участия в программе КР и выраженный рост ТФН в диапазоне ее исходно низких значений у пациентов с низким РП. Ключевые слова: острый инфаркт миокарда, кардиореабилитация, физические тренировки, реабилитационный потенциал, толерантность к физической нагрузке. Конфликт интересов: не заявлен.

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Daily Steps Threshold to Improve Cardiovascular Disease Risk Factors During the Year After an Acute Coronary Syndrome

Abstract: Targeting $7500 daily steps during 1 year may be efficient to maintain lowest waist circumference and to improve lipid profile during the year following an acute coronary syndrome. It could be considered a starting target point to initiate changes in physical activity behavior.

Cited by 20 publications

References 13 publications

Accuracy of a step counter during treadmill and daily life walking by healthy adults and patients with cardiac disease

Accuracy of a step counter during treadmill and daily life walking by healthy adults and patients with cardiac disease

Cardiac Patients’ Walking Activity Determined by a Step Counter in Cardiac Telerehabilitation: Data From the Intervention Arm of a Randomized Controlled Trial

Clinical effects of a one-year cardiac rehabilitation program using physical training after myocardial infarction in patients of working age with different rehabilitation potentials

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